Labor and delivery frequently asked questions

What are my birthing options with Nebraska Medicine?

Mothers can delivery vaginally or by cesarean delivery if necessary. We will support your desires as much as possible, whether you would like a natural labor and delivery or medication for pain relief. We routinely perform delayed umbilical cord clamping, increasing overall early developmental health for your baby.  We welcome the addition of family members and doulas for labor support. Our end goal is a healthy mom and baby!

Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. C-sections can be scheduled for certain pregnancy complications, or if you’ve had a previous C-section and don’t wish to attempt a vaginal birth. However, the need for a first time C-section may not become clear until after labor begins. We encourage skin-to-skin time with mom and baby, even during a C-section delivery.

Nebraska Medicine doctors have one of the lowest C-section rates in Omaha.

What if I want to deliver vaginally after a previous C-section?

Vaginal birth after cesarean (VBAC) is an option for some healthy mothers who would like to avoid a repeat cesarean delivery. There is a 60 to 80% success rate for mothers who attempt VBAC. At Nebraska Medicine, we offer induction of labor for VBACs when indicated or desired. However, certain risk factors, such as a high risk uterine scar or more than two C-sections, can make VBAC an inappropriate procedure for some women. Consult with your doctor or midwife to see whether VBAC is an option for your birth.

Nebraska Medicine physicians have one of the highest VBAC success rates in Omaha.

Can I have a water birth?

Nebraska Medicine offers hydrotherapy and water birth for families under our care. You may be a candidate for a water birth if you have a low-risk, full-term pregnancy with a single baby. Some patients who are not eligible for a water birth may still be able to utilize hydrotherapy during labor.

If you are interested in hydrotherapy or water birth, you should speak with your midwife or doctor during your prenatal appointments to determine if you are a candidate and to discuss the risks and benefits.

Can I be induced if I go over my due date?

Your “due date” is just an estimate based on the average pregnancy lasting 280 days (40 weeks). You are not actually considered to have a prolonged pregnancy until 294 days (42 completed weeks). In about half of all cases, first pregnancies last for 41 weeks or more.

If this is your first baby, there are recent studies showing that an induction of labor at 39 weeks may decrease the need for a cesarean delivery, without any increased risk to the mom or baby. In light of this research, you may have a discussion with your provider regarding induction at 39 weeks. At 41 weeks, the mother's and baby’s risk factors go up, so if you are still pregnant at a week past your due date, we would do testing to assess the wellbeing of both mom and baby. If at any point during this testing an indication is found, we would recommend induction of labor.

Induction of labor can be accomplished with a balloon, vaginal medication, and/or IV medication. Some of these procedures will require an IV in place and continuous fetal monitoring. Overall, we like to keep women moving while in labor, whether this is with walking, rolling on an exercise ball, or frequent position changes after an epidural is placed. Staying as mobile as possible helps the time go by faster and may also help rotate the baby into a better position for ease of delivery.

At 42 weeks the risk factors for you and your baby increase significantly. Induction is usually appropriate at this time. Consult with your doctor or midwife about the pros and cons of labor induction and what is best for you and your baby.

How frequently will I get ultrasounds?

Your doctor will work with you to schedule ultrasounds as necessary. Ultrasounds may be used in cases of concern about possible miscarriage, for genetic screenings that assess the risk of certain conditions such as Down syndrome and other birth defects, to check for normal fetal growth, or to check baby or placenta positioning.

Ultrasounds may be used more frequently for mothers with gestational diabetes, advanced maternal age, and medically complicated or high risk pregnancies.

Although there is no evidence that ultrasound is unsafe, it is wise to limit exposure for reasons other than those medically indicated by your doctor. It is best to have your ultrasound(s) at a qualified medical facility and only when your pregnancy care provider thinks it is necessary.

What are the differences among the types of Nebraska Medicine providers?

Obstetricians are highly trained physician specialists ready to handle any of the risks that come with pregnancy, labor, delivery and beyond. Obstetricians, neonatologists, and anesthesiologists are in the hospital at Nebraska Medicine 24/7, so you can breathe easy knowing you and your baby are in good hands. Skilled providers are available and prepared to deal with most any unexpected complication that may arise, day or night.

High risk obstetrical physician specialists provide expertise in complex pregnancies. They focus on the diagnosis and management of high risk pregnancies, allowing us to care for mothers and babies with significant medical concerns. We partner with other Nebraska Medicine medical and surgical specialists when needed to take care of both mom and baby.

You may also choose a family medicine doctor to provide your obstetrical care, in which case the physician who delivers your baby can be the one looking out for your child for years to come. As your child grows, care will be coordinated and consistent, so your whole family can stay healthy with us.

Midwives are another choice available for obstetrical care and delivery of low risk pregnancy. They can help make your prenatal care and birth feel special, with a high touch approach that gives moms a more intimate birthing experience, honoring a commitment to wellness and health. If you are a healthy mom who wants less invasive care with a personal touch, our midwives are ready to serve you.

Where can I learn more about the birth process?

Nebraska Medicine offers several informative classes about the birth process and breastfeeding. Classes are available at both the Nebraska Medical Center and the Bellevue Medical Center. Click here to learn more or to register.

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